Perioperative Management with Upfront Combination Therapy in a Patient Exhibiting Idiopathic Pulmonary Hypertension with Central Pulmonary Thrombosis
A 47-year-old woman with idiopathic pulmonary arterial hypertension (IPAH) was referred to our hospital for treatment of an ovarian tumor. Although chest contrast-enhanced CT scans obtained on admission revealed pulmonary arterial thrombosis, she was diagnosed with IPAH with central pulmonary thromb...
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| Veröffentlicht in: | Internal Medicine 2014, Vol.53(7), pp.777-781 |
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| container_title | Internal Medicine |
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| creator | Umezawa, Hiroki Terada, Jiro Tanabe, Nobuhiro Sugiura, Toshihiko Naito, Akira Nishikimi, Kyoko Sakao, Seiichiro Kasahara, Yasunori Yoshida, Yasuhide Tatsumi, Koichiro |
| description | A 47-year-old woman with idiopathic pulmonary arterial hypertension (IPAH) was referred to our hospital for treatment of an ovarian tumor. Although chest contrast-enhanced CT scans obtained on admission revealed pulmonary arterial thrombosis, she was diagnosed with IPAH with central pulmonary thrombosis based on a normal perfusion lung scan. We initiated upfront triple combination therapy with pulmonary vasodilators. After one month of the therapy, the patient's pulmonary hemodynamics improved. Gynecological surgery was performed under general anesthesia without any perioperative complications. Providing careful intensive management of patients with severe PAH can reduce the perioperative risks of non-cardiac and non-obstetric surgery. |
| doi_str_mv | 10.2169/internalmedicine.53.1355 |
| format | Article |
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Although chest contrast-enhanced CT scans obtained on admission revealed pulmonary arterial thrombosis, she was diagnosed with IPAH with central pulmonary thrombosis based on a normal perfusion lung scan. We initiated upfront triple combination therapy with pulmonary vasodilators. After one month of the therapy, the patient's pulmonary hemodynamics improved. Gynecological surgery was performed under general anesthesia without any perioperative complications. Providing careful intensive management of patients with severe PAH can reduce the perioperative risks of non-cardiac and non-obstetric surgery.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.53.1355</identifier><identifier>PMID: 24694496</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Anticoagulants - therapeutic use ; chronic thromboembolic pulmonary hypertension ; Drug Therapy, Combination ; Familial Primary Pulmonary Hypertension - drug therapy ; Familial Primary Pulmonary Hypertension - etiology ; Familial Primary Pulmonary Hypertension - physiopathology ; Female ; Follow-Up Studies ; general anesthesia ; Humans ; idiopathic pulmonary arterial hypertension ; Middle Aged ; Ovarian Neoplasms - surgery ; Ovariectomy ; Preoperative Care - methods ; pulmonary arterial thrombosis ; Pulmonary Embolism - complications ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - drug therapy ; Pulmonary Wedge Pressure ; Tomography, X-Ray Computed ; upfront combination therapy ; Vasodilator Agents - therapeutic use</subject><ispartof>Internal Medicine, 2014, Vol.53(7), pp.777-781</ispartof><rights>2014 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c471t-4a9e99e217616aa7589d9c349b64b207149a446a24e550467a1cf94c6d877a173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24694496$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Umezawa, Hiroki</creatorcontrib><creatorcontrib>Terada, Jiro</creatorcontrib><creatorcontrib>Tanabe, Nobuhiro</creatorcontrib><creatorcontrib>Sugiura, Toshihiko</creatorcontrib><creatorcontrib>Naito, Akira</creatorcontrib><creatorcontrib>Nishikimi, Kyoko</creatorcontrib><creatorcontrib>Sakao, Seiichiro</creatorcontrib><creatorcontrib>Kasahara, Yasunori</creatorcontrib><creatorcontrib>Yoshida, Yasuhide</creatorcontrib><creatorcontrib>Tatsumi, Koichiro</creatorcontrib><title>Perioperative Management with Upfront Combination Therapy in a Patient Exhibiting Idiopathic Pulmonary Hypertension with Central Pulmonary Thrombosis</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>A 47-year-old woman with idiopathic pulmonary arterial hypertension (IPAH) was referred to our hospital for treatment of an ovarian tumor. Although chest contrast-enhanced CT scans obtained on admission revealed pulmonary arterial thrombosis, she was diagnosed with IPAH with central pulmonary thrombosis based on a normal perfusion lung scan. We initiated upfront triple combination therapy with pulmonary vasodilators. After one month of the therapy, the patient's pulmonary hemodynamics improved. Gynecological surgery was performed under general anesthesia without any perioperative complications. Providing careful intensive management of patients with severe PAH can reduce the perioperative risks of non-cardiac and non-obstetric surgery.</description><subject>Anticoagulants - therapeutic use</subject><subject>chronic thromboembolic pulmonary hypertension</subject><subject>Drug Therapy, Combination</subject><subject>Familial Primary Pulmonary Hypertension - drug therapy</subject><subject>Familial Primary Pulmonary Hypertension - etiology</subject><subject>Familial Primary Pulmonary Hypertension - physiopathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>general anesthesia</subject><subject>Humans</subject><subject>idiopathic pulmonary arterial hypertension</subject><subject>Middle Aged</subject><subject>Ovarian Neoplasms - surgery</subject><subject>Ovariectomy</subject><subject>Preoperative Care - methods</subject><subject>pulmonary arterial thrombosis</subject><subject>Pulmonary Embolism - complications</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - drug therapy</subject><subject>Pulmonary Wedge Pressure</subject><subject>Tomography, X-Ray Computed</subject><subject>upfront combination therapy</subject><subject>Vasodilator Agents - therapeutic use</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkc1uEzEUhS0EoqHwCshLNpOOx3_jJYoKrVQgi3RteZybjqsZe7AdSh6E98XThAghNtd_3z3HugchTOplQ4S6cj5D9GYYYeus87DkdEko5y_QglCmKtlQ_hItakXaqinlAr1J6bGuaStV8xpdNEwoxpRYoF9riC5MEE12PwB_Md48wAg-4yeXe3w_7WIoh1UYO-cLEzze9IWeDth5bPC63M309c_edS47_4Bvt0XQ5N5ZvN4PY_AmHvDNoXhk8GlWeJZelbZohr-YTR-LTUguvUWvdmZI8O60XqL7T9eb1U119-3z7erjXWWZJLliRoFS0BApiDBG8lZtlS0D6ATrmloSpgxjwjQMOK-ZkIbYnWJWbFtZ9pJeog9H3SmG73tIWY8uWRgG4yHskyac0Jq1VLUFbY-ojSGlCDs9RTeWb2tS6zkU_W8omlM9h1Ja359c9l15PDf-SaEAX4_AY8pl_GfAxOzsAP9VlnM5OZxB25uowdPfC4uuNg</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Umezawa, Hiroki</creator><creator>Terada, Jiro</creator><creator>Tanabe, Nobuhiro</creator><creator>Sugiura, Toshihiko</creator><creator>Naito, Akira</creator><creator>Nishikimi, Kyoko</creator><creator>Sakao, Seiichiro</creator><creator>Kasahara, Yasunori</creator><creator>Yoshida, Yasuhide</creator><creator>Tatsumi, Koichiro</creator><general>The Japanese Society of Internal Medicine</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140101</creationdate><title>Perioperative Management with Upfront Combination Therapy in a Patient Exhibiting Idiopathic Pulmonary Hypertension with Central Pulmonary Thrombosis</title><author>Umezawa, Hiroki ; Terada, Jiro ; Tanabe, Nobuhiro ; Sugiura, Toshihiko ; Naito, Akira ; Nishikimi, Kyoko ; Sakao, Seiichiro ; Kasahara, Yasunori ; Yoshida, Yasuhide ; Tatsumi, Koichiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-4a9e99e217616aa7589d9c349b64b207149a446a24e550467a1cf94c6d877a173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Anticoagulants - therapeutic use</topic><topic>chronic thromboembolic pulmonary hypertension</topic><topic>Drug Therapy, Combination</topic><topic>Familial Primary Pulmonary Hypertension - drug therapy</topic><topic>Familial Primary Pulmonary Hypertension - etiology</topic><topic>Familial Primary Pulmonary Hypertension - physiopathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>general anesthesia</topic><topic>Humans</topic><topic>idiopathic pulmonary arterial hypertension</topic><topic>Middle Aged</topic><topic>Ovarian Neoplasms - surgery</topic><topic>Ovariectomy</topic><topic>Preoperative Care - methods</topic><topic>pulmonary arterial thrombosis</topic><topic>Pulmonary Embolism - complications</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - drug therapy</topic><topic>Pulmonary Wedge Pressure</topic><topic>Tomography, X-Ray Computed</topic><topic>upfront combination therapy</topic><topic>Vasodilator Agents - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Umezawa, Hiroki</creatorcontrib><creatorcontrib>Terada, Jiro</creatorcontrib><creatorcontrib>Tanabe, Nobuhiro</creatorcontrib><creatorcontrib>Sugiura, Toshihiko</creatorcontrib><creatorcontrib>Naito, Akira</creatorcontrib><creatorcontrib>Nishikimi, Kyoko</creatorcontrib><creatorcontrib>Sakao, Seiichiro</creatorcontrib><creatorcontrib>Kasahara, Yasunori</creatorcontrib><creatorcontrib>Yoshida, Yasuhide</creatorcontrib><creatorcontrib>Tatsumi, Koichiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Umezawa, Hiroki</au><au>Terada, Jiro</au><au>Tanabe, Nobuhiro</au><au>Sugiura, Toshihiko</au><au>Naito, Akira</au><au>Nishikimi, Kyoko</au><au>Sakao, Seiichiro</au><au>Kasahara, Yasunori</au><au>Yoshida, Yasuhide</au><au>Tatsumi, Koichiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perioperative Management with Upfront Combination Therapy in a Patient Exhibiting Idiopathic Pulmonary Hypertension with Central Pulmonary Thrombosis</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>53</volume><issue>7</issue><spage>777</spage><epage>781</epage><pages>777-781</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>A 47-year-old woman with idiopathic pulmonary arterial hypertension (IPAH) was referred to our hospital for treatment of an ovarian tumor. Although chest contrast-enhanced CT scans obtained on admission revealed pulmonary arterial thrombosis, she was diagnosed with IPAH with central pulmonary thrombosis based on a normal perfusion lung scan. We initiated upfront triple combination therapy with pulmonary vasodilators. After one month of the therapy, the patient's pulmonary hemodynamics improved. Gynecological surgery was performed under general anesthesia without any perioperative complications. 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| ispartof | Internal Medicine, 2014, Vol.53(7), pp.777-781 |
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| subjects | Anticoagulants - therapeutic use chronic thromboembolic pulmonary hypertension Drug Therapy, Combination Familial Primary Pulmonary Hypertension - drug therapy Familial Primary Pulmonary Hypertension - etiology Familial Primary Pulmonary Hypertension - physiopathology Female Follow-Up Studies general anesthesia Humans idiopathic pulmonary arterial hypertension Middle Aged Ovarian Neoplasms - surgery Ovariectomy Preoperative Care - methods pulmonary arterial thrombosis Pulmonary Embolism - complications Pulmonary Embolism - diagnosis Pulmonary Embolism - drug therapy Pulmonary Wedge Pressure Tomography, X-Ray Computed upfront combination therapy Vasodilator Agents - therapeutic use |
| title | Perioperative Management with Upfront Combination Therapy in a Patient Exhibiting Idiopathic Pulmonary Hypertension with Central Pulmonary Thrombosis |
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